Fatima A Masumova, DO

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

OS021046 Issued in PA

Practice address

15 Paddock St
Avenel, NJ 07001-1856

Phone

(732) 499-5041

NPI assigned

Apr 9, 2013

Last updated

Feb 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1730522756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 WINDSOR RD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080621875",
            "telephone_number": "908-907-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PADDOCK ST",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011856",
            "telephone_number": "732-499-5041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171101904",
            "country_code": "US",
            "telephone_number": "717-782-6420",
            "fax_number": "717-782-4727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASUMOVA",
        "first_name": "FATIMA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS021046",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "OS021046",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "PA",
            "license": "OS021046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fmasumova197335@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "address_1": "2501 N 3rd St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171101904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fatima.masumova2@doh.nj.gov",
            "affiliation": "N",
            "address_1": "15 Paddock St",
            "city": "Avenel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070011856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Magyarits
• Anna Makarova
• Sara Mangelsdorf
• Richard Mann, D.M.D
• Marc Mandel MD PC
• Jamie Mazzarelli
• Shannon McGinn, MA
• Justin Thomas McTish, OTD, OTR/L, CAPS
• Medigest Associates PA
• Medigest Healthcare Services LLC

• Forensic Psychiatry Physician in Avenel, NJ
• Providers in Avenel, NJ by specialty
• Forensic Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.